NPIMap

Organization Active NPI

KD Support Services

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Mooresboro, NC
National Provider Identifier
1609235696
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL-081-104 Issued in NC
Legal business name
KD SUPPORT SERVICES
Practice address
1998 Harris Henrietta Rd
Mooresboro, NC 28114-8209
Phone
(828) 657-4757
Fax
(828) 245-4099
NPI assigned
Feb 18, 2016
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Kenneth Dellinger, BS;QP
Title
Director of Operations
Phone
(828) 245-4011

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
KD Support Services (9 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL-081-104 NC Primary

Addresses

NPPES NPI Registry

Primary practice location

1998 Harris Henrietta Rd
Mooresboro, NC 28114-8209

Mailing address

158 US Highway 221a
Forest City, NC 28043-5600
Phone (828) 245-4011

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
3418462MedicaidNC

Other names 1

NPPES NPI Registry
  • Kellys Care 7 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 18, 2016.

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1609235696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 US HIGHWAY 221A",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280435600",
            "telephone_number": "828-245-4011",
            "fax_number": "828-245-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1998 HARRIS HENRIETTA RD",
            "city": "MOORESBORO",
            "state": "NC",
            "postal_code": "281148209",
            "telephone_number": "828-657-4757",
            "fax_number": "828-245-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KD SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "DELLINGER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "828-245-4011",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS;QP"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-081-104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418462",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kellys Care 7",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mooresboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.